PURPOSE This study aimed to compare the needs of family caregivers and program providers in family support program by exploring perspectives about the program in the long-term care system. METHODS This was a secondary analysis study using the content analysis method. The data of 11 family caregivers and 7 program providers that were collected from focus group interviews in two primary studies were used. Each data was collected in April and May 2015. The units of analysis were dyads of family caregivers and program providers. RESULTS The data were deductively analyzed within three main categories: program purpose, program content, and program method. Within the main categories, ten subcategories represented the essential elements for developing a family support program. There were differences between family caregivers and program providers in terms of the contents and intentions of the family support program. Family caregivers wanted to receive help from the family support program in a passive manner, while program providers expected the family support program to improve families' ability to solve their own problems. CONCLUSION Based on the results of this study, it is important to establish the strategies of customized and flexible program considering the needs of the caregivers to make family support program more effective. Further, it is necessary to fill the gap between the needs of the two groups and focus on family-centered approaches to conduct family support program more effectively.
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PURPOSE Nurses lead Evidence-Based Practice (EBP) in the healthcare system. To facilitate the evidence-based nursing process, nurses must have the knowledge and skills to formulate clinical questions in a searchable format. The purpose of this study was to develop an e-learning program on steps of EBP, especially focusing on clinical questioning to assess its effects. METHODS This research utilized a quasi-experimental study with a nonequivalent control group pre-post test design. The experimental group was provided an e-learning program with case-based animation. The control group was provided written material about EBP. The e-learning program was performed from October to November 2015. To evaluate the effects of the program, knowledge of EBP, attitude towards EBP, practice of EBP, clinical questioning confidence, and clinical questioning knowledge were evaluated. RESULTS There were significant differences in attitude towards EBP (t=2.08, p=.042), practice of EBP (t=2.06, p=.044), clinical questioning confidence (t=2.05, p=.045) and clinical questioning knowledge (t=2.08, p=.042). However, there was no significant difference between the experimental and control groups in knowledge of EBP (t=1.20, p=.237). CONCLUSION The e-learning program with case-based animation was an effective method to provide the EBP education to nurses. Further researches are needed to disseminate the case-based education to nurses and nursing students and to develop more diverse educational media.
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PURPOSE The aim of the study was to identify factors influencing quality of communication life of older adults in the community. METHODS Participants in this study were 128 older adults who registered at the community welfare center. The data were collected from September to October 2015 by using audiometer and three self-administered questionnaires including Korean Evaluation Scale for Hearing Handicap, Korean-Perceived Stress Scale, and Quality of Communication Life Scale. Mean minimal threshold of both ears was defined as 40dB and above for hearing handicap in this study. Data analysis included descriptive statistics, t-test, Pearson correlation coefficients, and hierarchical regression. RESULTS According to the screening test result from audiometer measurement, 53.9% of the participants were found to have hearing impairment. The main factors influencing quality of communication life in older adults were subjective hearing handicap of social domain and perceived stress. They explained about 41% of quality of communication life. CONCLUSION This study identified that subjective hearing handicap on social domain and self perceived stress in older adults were more important factors for their quality of communication life compared to physical hearing loss. Nurses caring for older people should include strategies to increases communication skills and to decrease communication related stress.
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PURPOSE The purposes of this study were to identify nurses' empathy, attitude and pain management for patients with dementia and the factors associated with their performance of pain management. METHODS The study design was a cross-sectional survey. The participants in the study were 114 nurses working at 12 geriatric hospitals. This study utilized the Interpersonal Reactivity Index (IRI), which measures four empathy factors. Nurses' attitudes toward pain and performance of pain management, and general and pain related characteristics were measured by self-administered questionnaires. RESULTS Barriers to pain management for patients with dementia were absence of guidelines, prejudice of pain in dementia, and lack of time and knowledge deficit. There was a significant positive correlation between empathic concern and attitudes, perspective-taking of empathy and pain management. There was also a correlation between empathy and pain management. Stepwise linear regression analysis indicated that the significant factors affecting the performance of pain management included perspective-taking of empathy, use of pain management in dementia guideline and attitudes toward pain. These factors explained 24.0% of variance. CONCLUSION The findings from this study suggest that empathy and positive attitude are the important provider attributes which needs to be enhanced by educational programs. It is also necessary to develop and disseminate guidelines for a dementia specific pain management.
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PURPOSE The purpose of this study was to explore how knowledge management of hospital and nurses' beliefs and competences on evidence-based practice can affect evidence-based decision making. METHODS In this descriptive study, a total of 184 nurses who were working in the five general hospitals participated. The data were collected through a self-administered questionnaire in September, 2014. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficient, and step-wise multiple regression with SPSS/WIN Statistics 21.0 program. RESULTS Evidence-based decision making was correlated with EBP beliefs (r=.55, p<.001), EBP competence (r=.57, p<.001), and knowledge management (r=.50, p<.001). Hierarchical regression analysis showed that EBP beliefs (β=.18, p=.005), EBP competence (β=.37, p<.001), organizational knowledge management (beta=.27, p<.001) explained 48.6% of evidence based decision making (p<.001). CONCLUSION The study results indicated that evidence-based practice competences, organizational knowledge management, and evidence-based practice beliefs were important factors on evidence-based decision making. In order to improve evidence-based practice among nurses through organizational knowledge management, EBP beliefs and competence at individual level need to be considered and incorporated into any systemic training of EBP.
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PURPOSE The purpose of this review was to assess the quality and to evaluate the effectiveness of music interventions in reducing agitation in older adults with dementia. METHODS Randomized controlled studies and randomized crossover studies were identified by searching MEDLINE, EMBASE, CINAHL, PsycINFO, AGELINE, Cochrane Central Register of Controlled Trials, Korea Med, Kmbase, RISS, National Assembly Digital Library, KISS, and RICH. Two reviewers independently retrieved articles, extracted data, and assessed the quality of studies. RESULTS In total, 10 studies were selected from 1095 unique citations. All included studies were conducted in long term care settings. Overall, risk of bias for included studies was low to moderate. The weighted average effect size across studies was -0.39 (95%CI [-0.69, -0.10], p=.009, I2=63%). Music therapy was effective to reduce agitation of the older adults with dementia. CONCLUSION Music intervention can be an effective non-pharmacological intervention for the reduction of agitation in dementia. Future studies need to use rigorous research method and to provide description of research methods in greater detail. In addition, future studies are required to explore the effects of music therapy according to severity of agitation and dementia.
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PURPOSE This study was to explore the gap between awareness and performance toward evidence-based pain management in older adults for the purpose of establishing baseline data for evidence-based pain management protocol development and dissemination. METHODS The subjects were 290 staff nurses from three general hospitals. Self administered questionnaires were used to collect the data and the results of the study were analyzed with descriptive statistics, t-test, ANOVA and Pearson's correlation. RESULTS There were statistically significant differences between awareness and performance in pain assessment (t=17.31, p<.001), patient and family education (t=17.33, p<.001), pharmacologic management (t=12.99, p<.001), non pharmacological management (t=16.28, p<.001), and evaluation of effectiveness (t=11.70, p<.001). There were also statistically significant differences in awareness and performance according to the workplace, knowledge, and usual performance. CONCLUSION The study showed that the hospital nurses' performance about evidence-based pain management in older adults was lower than their awareness level thus indicating significant gaps between evidence and actual practice. To ensure effective pain care, the factors contributing to these gaps need to be analyzed to identify the barriers. In addition, the evidence-based pain management guideline suitable for various clinical settings needs to be developed and disseminated.
PURPOSE The purpose of this study was to explore nurses' access and use of information resources and to identify the barriers and competency to evidence based practice (EBP). This study used descriptive method to identify baseline data for the purpose of developing strategies for establishing EBP in clinical nursing practice. METHODS Participants in this study were 278 nurses from five hospitals in Daegu and Kyungsangbukdo. The data were collected by self administered questionnaires and SPSS/WIN 15.0 program was used to analyze the data with descriptive statistics, t-test, Pearson's correlation coefficients, and ANOVA. RESULTS Nurses reported *most frequently using paper and human resources. The mean score of barriers was 3.02+/-0.41, and competency was 2.70+/-0.50. The reported competency was correlated with nurse factors (r=-.31, p<.001) organization factors (r=-.20, p<.001) and research factors (r=-.12, p<.040) as the barriers to evidence based practice. CONCLUSION To promote competency in EBP and to decrease the barriers, it would be necessary to develop the organizational culture that encourages nurses to be involved in research activities. In addition, the development of systemic methods to introduce and establish an education program for facilitating EBP in the clinical settings is needed.
PURPOSE This study was conducted to develop a Cancer Patient Guide with patients involvement using evidenced based practice research. The purpose of this patient guide was to help patients undergoing chemotherapy to manage their nausea and vomiting based on evidence. METHODS The design of the research was a methodological study. The participants consisted of seven cancer patients who were asked about their' need for nausea and vomiting management, and secondly, 16 expert & 15 cancer patients to evaluate the Cancer Patient Guide using the DESCERN tool. RESULTS 1) Sixty-four relevant research evidences based articles were reviewed. 2) Patients were interviewed as to their needs in controlling nausea and vomiting. 3) The preliminary Cancer Patient Guide utilizing the research evidenced and the cancer patients interviews was then evaluated and revised by the experts and cancer patients. Lastly, the Cancer Patient which included an overview of chemotherapy, pathophysiology of nausea & vomiting, pharmacological and non-pharmacological interventions was finalized with each intervention supported by research evidence and patients' narratives of their experience. CONCLUSION The Cancer Patient Guide was developed using evidenced based research and cancer patients in-put and be used to improve patients' self-management skill of nausea and vomiting in chemotherapy. The guide t also provides evidence based patient friendly information and contributes as a baseline data for developing and evaluating evidence-based guide for patients.
PURPOSE This study was to explore family member's caregiving stress and satisfaction of care for patients with dementia in long term care facilities and day care centers. METHODS: The subjects were 129 family members of elders with dementia from ten long term care facilities and eight day care centers in Daegu and Kyungsangbukdo. Data were collected from August to October, 2007. The instruments were self administered questionnaires and included. The Family Perceptions of Caregiving Role (FPCR) and the Family Perceptions of Care Tool (FPCT) which were developed by Maas and Buckwalter (1990) and translated by Park (2002). RESULTS: Family member's care giving stress in day care centers were higher than that of long term care facilities (t=-2.89, p=.005) especially in the categories of captivity (t=-3.27, p=.001), guilty (t=-2.93, p=.004), and loss (t=-2.44, p=.016). Family member's satisfaction of care in day care centers was higher than that of long term care facilities (t=-3.21, p=.002) in the (use - categories or measures since you are referring to the instrument and delete aspects) aspects of effective management (t=-3.69, p=.000) and activity (t=-2.00, p=.045). CONCLUSION: The results of this study showed that family members' perceptions toward their care giving roles and satisfaction of care differ whether the facilities are long term care or day care centers. This study provides baseline data that could be used for improving the quality of long term care services.
PURPOSE The purpose of this study was to evaluate the applicability of the evidence based guideline for prompted voiding by Lyons & Specht (2001) in National Guideline Clearinghouse(TM) for use in Korea based on the experts' opinions. METHOD: The target expert group consisted of 8 registered nurses, 6 physicians, and 5 nursing professors who are experts in urinary incontinence. This study used a questionnaire survey. The appropriateness, applicability, and the present application of each recommendation in the guideline were analyzed with descriptive statistics using the SPSS program, with content analysis based on the experts' opinions. RESULT: The scores on each recommendation's appropriateness showed the high degree of agreement among nurses, physicians, and nursing professors. However, the recommendation for 'use of oxybutinin' showed the lowest score as 5.89. It was notable that the most recommendations scored lower for applicability compared with appropriateness. The reasons for lower scores for applicability were the lack of clinicians' knowledge of assessment and management, and the lack of resources in clinical settings in Korea. CONCLUSION: This study will augment the understanding of the actual urinary incontinence management in Korean clinical settings and can be used as the baseline data for further study of tailoring international guidelines into local and national clinical settings.
PURPOSE The purpose of this study was to develop and evaluate e-EBPP(Evidence-based Practice Protocol) system for nursing care for patients with dementia to facilitate the best evidence-based decision in their dementia care settings. METHOD: The system was developed based on system development life cycle and software prototyping using the following 5 processes: Analysis, Planning, Developing, Program Operation, and Final Evaluation. RESULT: The system consisted of modules for evidence-based nursing and protocol, guide for developing protocol, tool for saving, revising, and deleting the protocol, interface tool among users, and tool for evaluating users' satisfaction of the system. On the main page, there were 7 menu bars that consisted of Introduction of site, EBN info, Dementia info, Evidence Based Practice Protocol, Protocol Bank, Community, and Site Link. In the operation of the system, HTML, JavaScript, and Flash were utilized and the content consisted of text content, interactive content, animation, and quiz. CONCLUSION: This system can support nurses' best and cost-effective clinical decision using sharable standardized protocols consisting of the best evidence in dementia care. In addition, it can be utilized as an e-learning program for nurses and nursing students to learn use of evidence based information.
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